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Tag: iab-birth control

  • How a medication abortion, also known as an ‘abortion pill,’ works | CNN

    How a medication abortion, also known as an ‘abortion pill,’ works | CNN



    CNN
     — 

    While the fate of mifepristone, one of two drugs used for medication abortions, is in the hands of the US Supreme Court, the drug continues to be available in states where abortion is legal.

    “While many women obtain medication abortion from a clinic or their OB-GYN, others obtain the pills on their own to self-induce or self-manage their abortion,” said Dr. Daniel Grossman, a professor of obstetrics, gynecology and reproductive sciences at the University of California, San Francisco.

    “A growing body of research indicates that self-managed abortion is safe and effective,” he said.

    Mifepristone blocks the hormone progesterone, which is needed for a pregnancy to continue. The drug is approved to end a pregnancy through 10 weeks’ gestation, which is “70 days or less since the first day of the last menstrual period,” according to the FDA.

    In a medication abortion, a second drug, misoprostol, is taken within the next 24 to 48 hours. Misoprostol causes the uterus to contract, creating cramping and bleeding. Approved for use in other conditions, such as preventing stomach ulcers, the drug has been available at pharmacies for decades.

    Together, the two drugs are commonly known as the “abortion pill,” which is now used in more than half of the abortions in the United States, according to the Guttmacher Institute, a research group that supports abortion rights.

    “Some people do this because they cannot access a clinic — particularly in states with legal restrictions on abortion — or because they have a preference for self-care,” said Grossman, who is also the director of Advancing New Standards in Reproductive Health, a research group that evaluates the pros and cons of reproductive health policies and publishes studies on how abortion affects a woman’s health.

    READ MORE: With US Supreme Court abortion drug hearing looming, study shows how self-managed abortion became more common post-Dobbs

    What happens during a medication abortion? To find out, CNN spoke with Grossman. This conversation has been condensed and edited for clarity.

    CNN: What is the difference between a first-trimester medication abortion and a vacuum aspiration in terms of what a woman experiences?

    Dr. Daniel Grossman: A vacuum aspiration is most commonly performed under a combination of local anesthetic and oral pain medications or local anesthetic together with intravenous sedation, or what is called conscious sedation.

    An injection of local anesthetic is given to the area around the cervix, and the cervix is gently dilated or opened up. Once the cervix is opened, a small straw-like tube is inserted into the uterus, and a gentle vacuum is used to remove the pregnancy tissue. Contrary to what some say, if the procedure is done before nine weeks or so, there’s nothing in the tissue that would be recognizable as a part of an embryo.

    The aspiration procedure takes just a couple of minutes. Then the person is observed for one to two hours until any sedation has worn off. We also monitor each patient for very rare complications, such as heavy bleeding.

    A medication abortion is a more prolonged process. After taking the pills, bleeding and cramping can occur over a period of days. Bleeding is typically heaviest when the actual pregnancy is expelled, but that bleeding usually eases within a few hours. On average people continue to have some mild bleeding for about two weeks or so, which is a bit longer than after a vacuum aspiration.

    Nausea, vomiting, fever, chills, diarrhea and headache can occur after using the abortion pill, and everyone who has a successful medication abortion usually reports some pain.

    In fact, the pain of medication abortion can be quite intense. In the studies that have looked at it, the average maximum level of pain that people report is about a seven to eight out of 10, with 10 being the highest. However, people also say that the pain can be brief, peaking just as the pregnancy is being expelled.

    The level of cramping and pain can depend on the length of the pregnancy as well as whether or not someone has given birth before. For example, a medical abortion at six weeks or less gestation typically has less pain and cramping than one performed at nine weeks. People who have given birth generally have less pain.

    CNN: What can be done to help with the pain of a medication abortion?

    Grossman: There are definitely things that can be used to help with the pain. Research has shown that ibuprofen is better than acetaminophen for treating the pain of medication abortion. We typically advise people to take 600 milligrams every six hours or so as needed.

    Some people take tramadol, a narcotic analgesic, or Vicodin, which is a combination of acetaminophen and hydrocodone. Recent research I was involved in found medications like tramadol can be helpful if taken prophylactically before the pain starts.

    Another successful regimen that we studied combined ibuprofen with a nausea medicine called metoclopramide that also helped with pain. Other than ibuprofen, these medications require a prescription.

    Another study found that a TENS device, which stands for transcutaneous electrical nerve stimulator, helps with the pain of medication abortion. It works through pads put on the abdomen that stimulate the nerves through mild electrical shocks, thus interfering with the pain signals. That’s something people could get without a prescription.

    Pain can be an overlooked issue with medication abortion because, quite honestly, as clinicians, we’re not there with patients when they are in their homes going through this. But as we’ve been doing more research on people’s experiences with medication abortion, it’s become quite clear that pain control is really important. I think we need to do a better job of treating the pain and making these options available to patients.

    CNN: Are there health conditions that make the use of a medication abortion unwise?

    Grossman: Undergoing a medication abortion can be dangerous if the pregnancy is ectopic, meaning the embryo is developing outside of the uterus. It’s rare, happening in about two out of every 100 pregnancies — and it appears to be even rarer among people seeking medication abortion.

    People who have undergone previous pelvic, fallopian tube or abdominal surgery are at higher risk of an ectopic pregnancy, as are those with a history of pelvic inflammatory disease. Certain sexually transmitted infections can raise risk, as does smoking, a history of infertility and use of infertility treatments such as in vitro fertilization (IVF).

    If a person is on anticoagulant or blood thinning drugs or has a bleeding disorder, a medication abortion is not advised. The long-term use of steroids is another contraindication for using the abortion pill.

    Anyone using an intrauterine device, or IUD, must have it removed before taking mifepristone because it may be partially expelled during the process, which can be painful.

    People with chronic adrenal failure or who have inherited a rare disorder called porphyria are not good candidates.

    CNN: Are there any signs of trouble a woman should watch for after undergoing a medication abortion?

    Grossman: It can be common to have a low-grade fever in the first few hours after taking misoprostol, the second drug in a medication abortion. If someone has a low-grade fever — 100.4 degrees to 101 degrees Fahrenheit — that lasts more than four hours, or has a high fever of over 101 degrees Fahrenheit after taking the medications, they do need to be evaluated by a health care provider.

    Heavy bleeding, which would be soaking two or more thick full-size pads an hour for two consecutive hours, or a foul-smelling vaginal discharge should be evaluated as well.

    One of the warning signs of an ectopic pregnancy is severe pelvic pain, particularly on one side of the abdomen. The pain can also radiate to the back. Another sign is getting dizzy or fainting, which could indicate internal bleeding. These are all very rare complications, but it’s wise to be on the lookout.

    We usually recommend that someone having a medication abortion have someone with them during the first 24 hours after taking misoprostol or until the pregnancy has passed. Many people specifically choose to have a medication abortion because they can be surrounded by a partner, family or friends.

    Most people know that the abortion is complete because they stop feeling pregnant, and symptoms such as nausea and breast tenderness disappear, usually within a week of passing the pregnancy. A home urine pregnancy test may remain positive even four to five weeks after a successful medication abortion, just because it takes that long for the pregnancy hormone to disappear from the bloodstream.

    If someone still feels pregnant, isn’t sure if the pregnancy fully passed or has a positive pregnancy test five weeks after taking mifepristone, they need to be evaluated by a clinician.

    People should know that they can ovulate as soon as two weeks after a medication abortion. Most birth control options can be started immediately after a medication abortion.

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  • FDA advisers vote unanimously in support of over-the-counter birth-control pill | CNN

    FDA advisers vote unanimously in support of over-the-counter birth-control pill | CNN



    CNN
     — 

    Advisers for the US Food and Drug Administration voted unanimously on Wednesday in support of making the birth-control pill Opill available over-the-counter, saying the benefits outweigh the risks.

    Two FDA advisory panels agreed that people would use Opill safely and effectively and said groups such as adolescents and those with limited literacy would be able to take the pill at the same time every day without help from a health care worker.

    The advisers were asked to vote on whether people were likely to use the tablet properly so that the benefits would exceed the risks. Seventeen voted yes. Zero voted no or abstained.

    Opill manufacturer Perrigo hailed the vote as a “groundbreaking” move for women’s health.

    “Perrigo is proud to lead the way in making contraception more accessible to women in the U.S.,” Murray Kessler, Perrigo’s president and CEO, said in a statement. “We are motivated by the millions of people who need easy access to safe and effective contraception.”

    The FDA doesn’t have to follow its advisers’ advice, but it often does. It is expected to decide whether to approve the over-the-counter pill this summer.

    If it’s approved, this will be the first birth-control pill available over the counter in the United States. Opill is a “mini-pill” that uses only the hormone progestin.

    At Wednesday’s meeting, Dr. Margery Gass of the University of Cincinnati College of Medicine thanked the FDA for its consideration of switching Opill to an over-the-counter product.

    “I think this represents a landmark in our history of women’s health. Unwanted pregnancies can really derail a woman’s life, and especially an adolescent’s life,” she said.

    The FDA has faced pressure to allow Opill to go over-the-counter from lawmakers as well as health care providers.

    Unwanted pregnancies are a public health issue in the US, where almost half of all pregnancies are unintended, and rates are especially high among lower-income women, Black women and those who haven’t completed high school.

    In March 2022, 59 members of Congress wrote a letter to FDA Commissioner Dr. Robert Califf about OTC contraception.

    “This is a critical issue for reproductive health, rights, and justice. Despite decades of proven safety and effectiveness, people still face immense barriers to getting birth control due to systemic inequities in our healthcare system,” the lawmakers wrote.

    A recent study showed that it’s become harder for women to access reproductive health care services more broadly – such as routine screenings and birth control – in recent years.

    About 45% of women experienced at least one barrier to reproductive health care services in 2021, up 10% from 2017. Nearly 19% reported at least three barriers in 2021, up from 16% in 2017.

    Increasing reproductive access for women and adolescents was a resounding theme among the FDA advisers.

    “We can take this opportunity to increase access, reduce disparities and, most importantly, increase the reproductive autonomy of the women of our nation,” said Dr. Jolie Haun of the James A. Haley Veterans’ Hospital and the University of Utah.

    Dr. Karen Murray, deputy director of the FDA’s Office of Nonprescription Drugs, said the agency understands the importance of “increased access to effective contraception” but hinted that the FDA would need more data from the manufacturer.

    Some of the advisers and FDA scientists expressed concern that some of Perrigo’s data was unreliable due to overreporting of “improbable dosing.”

    Murray said the lack of sufficient information from the study poses challenges for approval.

    “It would have been a much easier time for the agency if the applicant had submitted a development program and an actual use study that was very easy to interpret and did not have so many challenges. But that was not what happened for us. And so the FDA has been put in a very difficult position of trying to determine whether it is likely that women will use this product safely and effectively in the nonprescription setting,” she said. “But I wanted to again emphasize that FDA does realize how very important women’s health is and how important it is to try to increase access to effective contraception for US women.”

    Ultimately, the advisers said, they don’t want further studies of Opill to delay the availability of the product in an over-the-counter setting.

    “I just wanted to say that the improbable dosing issue is important, and I don’t think it’s been adequately addressed and certainly leads to some uncertainty in the findings. But despite this, I would not recommend another actual use study this time, and I think we can make a decision on the totality of the evidence,” said Kate Curtis of the US Centers for Disease Control and Prevention.

    Curtis said she voted yes because “Opill has the potential to have a huge positive public health impact.”

    Earlier in the discussion, Dr. Leslie Walker-Harding of the University of Washington and Seattle Children’s Hospital said the pill is just as safe as many other medications available on store shelves.

    “The safety profile is so good that we would need to take every other medicine off the market like Benadryl, ibuprofen, Tylenol, which causes deaths and people can get any amount of that without any oversight. And this is extremely safe, much safer than all three of those medications, and incorrect use still doesn’t appear to have problematic issues,” she said.

    Dr. Katalin Roth of the George Washington University School of Medicine and Health Sciences also emphasized the safety of the pill over the 50 years it has been approved as a prescription drug in the US.

    “The risks to women of an unintended pregnancy are much greater than any of the things we were discussing as risks of putting this pill out out over-the-counter,” she said. “The history of women’s contraception is a struggle for women’s control over their reproduction, and we need to trust women.”

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  • Iowa’s attorney general has paused funding for sexual assault victims’ Plan B and abortions | CNN

    Iowa’s attorney general has paused funding for sexual assault victims’ Plan B and abortions | CNN



    CNN
     — 

    Iowa’s Attorney General has paused funding for emergency contraception and abortions for sexual assault victims, according to an email Iowa’s Coalition Against Sexual Assault received that was also shared with CNN.

    The email was sent from Chief Deputy Attorney General Sam Langholz. Attorney General Brenna Bird’s office did not respond to CNN’s request for comment.

    Langholz told the nonprofit that a review of victim’s services is ongoing and the Attorney General has not made a final decision on whether the payments will resume.

    “While not required by Iowa law, the victim compensation fund has previously paid for Plan B and abortions. As a part of her top-down, bottom-up audit of victim assistance, Attorney General Bird is carefully evaluating whether this is an appropriate use of public funds,” Bird’s Press Secretary Alyssa Brouillet said in a statement to the Des Moines Register. “Until that review is complete, payment of these pending claims will be delayed.”

    Langholz shared the same statement from Bird’s press secretary in the email obtained by CNN.

    Under the 1979 Iowa Sexual Abuse Examination Payment Program, victims of sexual assault in Iowa are “never responsible for a sexual abuse forensic examination or for medications required due to the assault,” according to Iowa’s Victim Assistance annual report.

    Though it was not explicitly required, it has been the state’s longtime policy to cover the cost of emergency contraception under the victim compensation fund, and in rare cases, the fund has also paid for abortions for rape victims, Sandi Tibbetts Murphy, director of the victim assistance division under the previous attorney general, told the Des Moines Register.

    After Bird took office, Tibbetts Murphy resigned at request of the new attorney general, the Des Moines Register reported.

    Funds for the program are entirely made up of fines and penalties paid by convicted criminals, rather than general taxpayer money – a point victim advocacy groups emphasize.

    “Victims of rape and child abuse have an acute need for timely access to health services, including contraception to prevent unintended pregnancy and abortion care. Cost should never be a barrier for rape victims seeking medical care,” Iowa’s Coalition Against Sexual Assault said in a statement Monday, urging the attorney general to continue the payments to sexual assault victims. “Using offender accountability victim compensation funds to cover the cost of forensic exams, incentivizes victims to undergo an invasive exam that can help prevent offenders from victimizing others and enhance access to medical care for crime victims.”

    Ruth Richardson, CEO of Planned Parenthood North Central States, called Bird’s decision “deplorable and reprehensible,” saying it “further demonstrates politicians’ crusade against Iowans’ health and rights,” according to a statement.

    Bird, a Republican, won her election in 2022 in a race that largely focused on abortion after her Democratic opponent declined to defend Iowa’s “fetal heartbeat” law, which would ban most abortions after about six weeks.

    During her campaign, Bird said, “I am pro-life and I will defend the laws that are passed by the Legislature.”

    Iowa’s Coalition Against Sexual Assault says that ensuring victims are not responsible for the cost of a forensic exam or for needed medications after an assault is “key to encouraging victims to undergo this extremely invasive medical exam as soon as possible after a violent assault.”

    Juveniles accounted for the majority of sexual abuse victim costs paid for by Iowa’s state victim compensation funds, according to a 2021 Iowa’s Victim Assistance report.

    Nearly 2.9 million women across the US experienced rape-related pregnancy during their lifetime, according to a study published in 2018 by the American Journal of Preventative Medicine.

    “Emergency contraception should be provided to victims of sexual assault, requiring its immediate availability in hospitals and other facilities where sexual assault victims are treated,” the American College of Obstetricians and Gynecologists says on its website.

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  • Morning after pill brand speeds up retail access, doubles supply per pack | CNN Business

    Morning after pill brand speeds up retail access, doubles supply per pack | CNN Business


    New York
    CNN
     — 

    One maker said it is responding to high demand for the morning-after pill, after the US Supreme Court last year ended a constitutional right to abortion, by speeding up availability of the emergency contraceptive in retail stores and introducing a new two-count pack.

    Julie launched as a one-step tablet of emergency contraceptive containing Levonorgestrel, the key ingredient in the popular Plan B emergency contraceptive that was approved by FDA in late 1990s without a prescription, at 4,500 Walmart stores nationwide last September.

    The startup experienced a surge in demand for its $42 tablet at launch amid an overall spike in purchases of emergency contraceptive following the US Supreme Court’s ruling overturning Roe v. Wade in on June 24, 2022.

    The FDA-approved morning-after pill can reduce the chance of pregnancy after unprotected sex or failure of another contraceptive method like a condom, and is ideally taken within 72 hours. The pill, which is legal in all 50 US states, works by delaying ovulation or preventing implantation and cannot terminate a pregnancy.

    While the plan from the beginning was always to make the product widely accessible as quickly possible, the Supreme Court’s ruling only compelled the startup to accelerate the timetable for Julie’s nationwide rollout.

    “The Dobbs decision and overturning Roe v. Wade last year rocked everyone’s world, our customers and our retail partners,” said Amanda E/J Morrison, cofounder of Julie. “It lit a fire under us to provide our product to more women and, more importantly, to educate women about emergency contraceptives.”

    In April, just seven months after hitting the market, Julie is now expanding into 5,600 CVS stores and 1,500 Target stores. The brand is also introducing a new 2-count pack of its emergency contraception (which has a three-year expiration period). The two-count pack rolled out at CVS locations over the weekend.

    “With the two-pack, we want to make it easier for women to keep extra emergency contraceptive at home, just like they would with other birth control options like condoms,” said Morrison.

    The price for two-count pack is $70. Morrison said the pill works most effectively the closer it is taken after unprotected sex, ideally within 72 hours.

    Dr. Colleen Denny, a clinical associate professor in the department of obstetrics and gynecology at NYU Grossman School of Medicine, said she saw the upside to a two-count pack of emergency contraception, which she hasn’t seen before from other emergency contraception brands.

    “It generally makes sense for barriers to emergency contraception, prescription and over the counter, to be as low as possible,” said Denny,

    “Emergency contraception is incredibly safe and effective at preventing pregnancy when used in the right time frame,” she said. “Relationships are complicated. There can be situations where there isn’t access to emergency contraception or women might not ask the partner to use it. So being able to have access to one pill and a backup is a great idea.”

    Kelly Cleland, executive director of the American Society for Emergency Contraception, said emergency contraception brands, like Julie, still have to work harder at making the product not only more accessible, but also more affordable.

    “I am in favor of expanding access, but this is a missed opportunity when a generic brand comes into the market with a high price barrier,” Cleland said about Julie’s $70 price for the two-count pack.

    Cleland said a study done last year by the American Society for Emergency Contraception on access to emergency contraception in stores compared price at retail for branded and generic emergency contraception options. The report said some generic options were priced at $6 or less.

    Julie said it set the price for its single pill and two-count pack so it can fund its one-for-one donation program (in which the company donates one box for every box purchased) and to cover business costs tied to packaging and marketing.

    By overturning Roe v. Wade, the Supreme Court revoked the notion that the constitutional right to privacy included an abortion. In Dobbs v. Jackson Women’s Health Organization, the Supreme Court expanded states’ authority to regulate or restrict abortion.

    A total of 26 US states have since implemented new abortion restrictions or all-out bans.

    In the rulings’ immediate aftermath, doctors and prescribers saw a sharp jump in demand for different forms of contraception, including emergency contraception, and longer-lasting forms of birth control. The rush on emergency contraceptives forced some pharmacy chains to impose temporary purchase limits.

    “Every time there is a new development on restrictions to reproduction health care, there’s a run on emergency contraceptive. Our retail partners confirmed this,” said Morrison, adding that news events continue to influence buying patterns for emergency contraceptive.

    “The current political climate has emboldened Julie,” Morrison said. This, according to the company, includes expanding Julie’s available within communities through unexpected places like bars, restaurants and coffee shops.

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  • 19th century chastity law endangers 21st century abortion medicine | CNN Politics

    19th century chastity law endangers 21st century abortion medicine | CNN Politics

    A version of this story appears in CNN’s What Matters newsletter. To get it in your inbox, sign up for free here.



    CNN
     — 

    The Wild West of the post-Roe v. Wade legal landscape is focused on a lone federal judge in Amarillo, Texas, who could use a 19th century law to limit access to abortion medication for every American woman.

    The judge, 45-year-old Matthew Kacsmaryk, held a hearing Wednesday about whether he should impose a preliminary injunction that would require the US Food and Drug Administration to withdraw or suspend its approval of the drug, mifepristone, while a larger case progresses.

    Mifepristone is taken along with another drug, misoprostol, as part of the two-step medication abortion process. Misoprostol can be prescribed on its own, but it is considered less effective.

    Kacsmaryk, who sounded open to the idea of restricting access to mifepristone, will have to agree with some or all of these general points raised if he decides to issue an injunction:

    • That doctors who don’t perform abortions and live in Texas, where abortions are already banned, are harmed by abortions conducted elsewhere.
    • That an FDA approval conducted over the course of four years and finalized 23 years ago was so flawed that it should be rescinded.
    • That a single federal judge in Amarillo should do what no federal judge has ever done and unilaterally rescind an FDA approval.
    • That a drug, which studies suggest is on par with ibuprofen in terms of safety, is actually so harmful it should be reconsidered by the FDA.

    CNN’s Tierney Sneed wrote a longer list of takeaways from the hearing, where anti-abortion rights doctors and activist groups teed up their lawsuit in Kacsmaryk’s courtroom to further limit access to abortion care in the US.

    It’s important to note that no matter what Kacsmaryk does, it will be appealed up through the 5th US Circuit Court of Appeals and potentially to the Supreme Court.

    But perhaps the most incredible question Kacsmaryk faces is whether an 1870s chastity law named for an anti-vice crusader, Anthony Comstock, should be resuscitated and applied to the medicine that now accounts for a majority of US abortions.

    Comstock operated the New York Society for the Suppression of Vice and was a special agent of the US Postal Service. He was known for seizing contraband like contraceptives and condoms in the name of rooting out obscenity, according to the New York Historical Society.

    Mary Ziegler, a law professor at the University of California, Davis who has written about the Comstock Act for CNN Opinion, described Comstock as being “obsessed by what he saw as the decaying morals of a country preoccupied with sex.”

    Ziegler writes:

    The law he inspired barred not just the mailing of “obscene books” but also birth control and abortion drugs and devices. In the 19th and early 20th centuries, the Comstock Act was used to prohibit the mailing of many literary classics, from Geoffrey Chaucer’s “The Canterbury Tales” to works by James Joyce and Walt Whitman.

    Comstock himself proudly carried a gun and scoured the mail for cases involving information about abortion or contraception, even if a doctor provided it. By Comstock’s standard, the law was a great success: he claimed to have destroyed 15 tons of books, arrested more than 4,000 people and driven at least 15 people to suicide.

    While Congress has acted to relax elements of the Comstock Act, including to allow the mailing of contraceptives, it is still technically on the books with regard to the mailing of anything that could be used for an abortion.

    During the Covid-19 pandemic, the FDA dropped its requirement that a person obtain mifepristone in person. A prescription is still required.

    In December, the Department of Justice notified the US Postal Service that the Comstock Act did not apply as long as “the sender lacks the intent that the recipient of the drugs will use them unlawfully.”

    The FDA permanently removed the in-person requirement in January, hoping to guarantee more access to the medication after the Supreme Court ended Roe v. Wade last June.

    The group that brought the Texas lawsuit, the Alliance for Hippocratic Medicine, wants to reapply the Comstock Act and restrict the mailing of abortion medication.

    The FDA’s already exhaustive and detailed drug approval process was especially scrutinized for mifepristone, which was more commonly known as part of the RU-486 regimen when it became available to American women at the turn of the century.

    It had been available in Europe for a dozen years before that. Here’s CNN’s report from September 2000.

    That the drug works safely as a means of abortion is not really up for dispute as a medical matter after all that time, according to CNN’s Jen Christensen, who explains more about the medication in this article about mifepristone.

    Another CNN data analysis suggests mifepristone is safer than penicillin and Viagra.

    Mifepristone has a death rate of 0.0005% – five deaths for every 1 million people in the US who used it. Penicillin’s death rate is four times greater. Viagra’s is 10 times greater, according to the analysis by CNN’s Annette Choi and Will Mullery.

    Kacsmaryk had a long history of challenging laws providing greater access to reproductive rights before he became a federal judge. While he has promised to be an impartial judge, every Democrat and one Republican, Sen. Susan Collins of Maine, opposed his nomination in 2019.

    Now Kacsmaryk is the only federal judge at the courthouse in Amarillo, which almost guarantees he hears cases filed there.

    So it may be no coincidence that the group challenging use of mifepristone set up an outpost months before filing its lawsuit. The group is based in Tennessee, but one of the doctors named as a plaintiff in the lawsuit practices near Amarillo.

    However one feels about judicial shopping and whether that happened in this case, the word appears to be out that a conservative judge is alone in Amarillo and open for business.

    According to a CNN profile, Kacsmaryk has also put on hold Biden administration policies related to immigration and overseen cases related to vaccine requirements and gender identity. Last December, he halted a federal program in Texas that allowed minors to get birth control without their parents’ consent.

    That suit regarding the birth control program established in 1970 was brought by a Texas father “raising each of his daughters in accordance with Christian teaching on matters of sexuality,” which he said forbids premarital sex.

    Kacsmaryk agreed, even citing the Catechism of the Catholic Church in his decision to say “contraception (just like abortion) violates traditional tenets of many faiths, including the Christian faith Plaintiff practices.”

    His sister described him to The Washington Post as an anti-abortion rights activist and detailed her own decision to give a child up for adoption rather than seek an abortion.

    “He’s very passionate about the fact that you can’t preach pro-life and do nothing,” Jennifer Griffith told the Post. “We both hold the stance of you have to do something. You can’t not.”

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  • First on CNN: Biden administration to strengthen Obamacare contraceptive mandate in proposed rule | CNN Politics

    First on CNN: Biden administration to strengthen Obamacare contraceptive mandate in proposed rule | CNN Politics



    CNN
     — 

    The Biden administration wants to make it easier for women to access birth control at no cost under the Affordable Care Act, reversing Trump-era rules that weakened the law’s contraceptive mandate for employer-provided health insurance plans.

    The proposed rule, unveiled Monday by the departments of Health and Human Services, Labor and Treasury, would remove an exemption to the mandate that allows employers to opt out for moral convictions. It would also create an independent pathway for individuals enrolled in plans offered by employers with religious exemptions to access contraceptive services through a willing provider without charge.

    The proposed rule would leave in place the existing religious exemption for employers with objections, as well as the optional accommodation for contraceptive coverage.

    The administration crafted the proposed rule keeping in mind the concerns of employers with religious objections and the contraceptive needs of their workers, a senior HHS official told CNN.

    “We had to really think through how to do this in the right way to satisfy both sides, but we think we found that way,” the official said, stressing that there should be no effect on religiously affiliated employers.

    Students at religiously affiliated colleges would have access to the expanded accommodation, just like workers in group health plans where the employer has claimed the exemption.

    Now that the proposed rule has been announced, the public will have the opportunity to comment during the next few months. Officials expect there to be many thousands of public comments, and it will be “many months” before the rule could be finalized.

    HHS expects the proposal would affect more than 100 employers and 125,000 workers, mainly through providing the proposed independent pathway for employees to receive no-cost contraception.

    Women using that pathway would obtain their birth control from a participating provider, who would be reimbursed by an insurer on the Affordable Care Act exchanges. The insurer, in turn, would receive a credit on the user fee it pays the government.

    “If this rule is finalized, individuals who have health plans that would otherwise be subject to the ACA preventive services requirements but have not covered contraceptive services because of a moral or religious objection, and for which the sponsoring employer or college or university has not elected the optional accommodation, would now have access,” Centers for Medicare and Medicaid Services Administrator Chiquita Brooks-LaSure said in a news release.

    How many people benefit, however, would depend on whether women and their health care providers know the independent pathway exists and whether providers and insurers are willing to set it up.

    “We’ll just have to see how widely that information is spread and in what way to providers and individuals,” said Laurie Sobel, associate director for Women’s Health Policy at the Kaiser Family Foundation, noting that the proposed rule would not require data collection to show the pathway’s takeup.

    But the Planned Parenthood Federation of America cheered the initiative.

    “Employers and universities should not be able to dictate personal health care decisions and impose their views on their employees or students,” said Alexis McGill Johnson, the group’s CEO. “The ACA mandates that health insurance plans cover all forms of birth control without out-of-pocket costs. Now, more than ever, we must protect this fundamental freedom.”

    The requirement to provide no-cost contraception is not in the Affordable Care Act itself. Instead, HHS under former President Barack Obama included it as one of the women’s preventive services that all private insurance plans must offer without charge.

    The mandate was controversial from the start, sparking lawsuits from religiously affiliated employers and closely held companies that said it violated their beliefs. Exemptions and accommodations have been available for such employers.

    The Trump administration, however, weakened the mandate. Under the rules issued in 2018, entities that have “sincerely held religious beliefs” against providing contraceptives are not required to do so. That provision also extends to organizations and small businesses that have objections “on the basis of moral conviction which is not based in any particular religious belief.”

    The rules also include an optional accommodation that lets objecting employers and private universities remove themselves from providing birth control coverage while still allowing their workers and dependents access to contraception. But the employer or university has to voluntarily elect the accommodation, which risks leaving many without access.

    The Trump administration changes were temporarily blocked after a Pennsylvania district court judge issued a nationwide injunction in 2019. But the following year, the Supreme Court ruled that the administration could expand exemptions for employers who have religious or moral objections to covering contraception.

    At the time, the National Women’s Law Center estimated that the ruling would impact about 64.3 million women in the United States with insurance coverage that included birth control and other preventive services without out-of-pocket costs.

    Employers are not required to notify HHS if they have a moral objection. The agency estimates about 18 employers have claimed that exemption and around 15 employees are affected.

    Still, if the rule is finalized, senior HHS officials say it is “plausible” there could be potential lawsuits brought by religiously affiliated employers – similar to what has been seen in the past.

    “There’s no new obligation on them to participate in any sort of process. This is simply an additional channel for employees in those employer health plans to receive access to contraceptive services,” another senior HHS official said.

    The contraceptive mandate has taken on increased importance now that the Supreme Court has overturned Roe v. Wade, allowing many states to impose severe restrictions on abortion access.

    The Biden administration in turn has focused on continuing access to birth control at no cost. The Health, Labor and Treasury department secretaries last year met with health insurers and issued guidance underscoring Obamacare’s contraceptive coverage requirements for private insurance under the Affordable Care Act.

    “Now more than ever, access to and coverage of birth control is critical as the Biden-Harris Administration works to help ensure women everywhere can get the contraception they need, when they need it, and – thanks to the ACA – with no out-of-pocket cost,” HHS Secretary Xavier Becerra said in a news release.

    This story has been updated with additional information.

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  • France offers free condoms to young people and free emergency contraception to all women | CNN

    France offers free condoms to young people and free emergency contraception to all women | CNN



    CNN
     — 

    Free condoms are now available to young people under the age of 26 at French pharmacies as part of what French President Emmanuel Macron has called “a small revolution in preventative healthcare.”

    The new health strategy, which aims to curb the spread of sexually transmitted diseases (STDs) among young people in France, came into place on New Year’s Day and was announced by Macron in December. It was initially aimed at those aged 18-25, but was later extended to minors.

    Emergency contraception will also be available for free to all women without a prescription as of January 1, according to a tweet from government spokesperson Olivier Veran on Monday.

    Since January 1, 2022, French women under the age of 26 already had access to free contraception. This included consultations with doctors or midwives and medical procedures associated with their chosen contraceptive.

    The latest measures come as health authorities estimate that the rate of STDs in France increased by about 30% in 2020 and 2021, Reuters news agency reported.

    “It’s a small revolution in preventative healthcare. It’s essential so that our young people protect themselves during sexual intercourse,” Macron said in December.

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